VA rates gastroesophageal reflux disease (GERD) under diagnostic code 7206, with ratings of 0%, 10%, 30%, 50%, or 80%. Since May 19, 2024, the rating depends mainly on whether you have a documented esophageal stricture (a narrowing of the esophagus, often from scarring) and how it’s treated, rather than on reflux symptoms alone. If you’re a veteran with chronic heartburn or trouble swallowing, understanding these criteria can help you know what records matter.
Key takeaways
- About 18% to 28% of adults in North America have GERD, and VA now rates it under its own diagnostic code.
- Ratings above 0% require a documented esophageal stricture, with higher ratings for strictures that need repeated dilation, stents, surgery, or a feeding tube.
- If your GERD may be linked to service or to a service-connected condition, your medical records and a well-reasoned medical opinion are the evidence VA weighs.
What is GERD?
GERD is a long-term condition in which stomach contents flow back into the esophagus often enough to cause symptoms or damage. About 20% of people in the United States are estimated to have it.
Over time, GERD can lead to complications such as:
- Esophagitis, inflammation that can cause ulcers and bleeding
- Esophageal stricture, a narrowing that makes swallowing difficult (dysphagia)
- Barrett’s esophagus, a change in the lining of the esophagus that raises cancer risk in a small number of people
A systematic review of GERD epidemiology estimated its prevalence in North America at 18.1% to 27.8%, among the highest of any region studied.
Proton pump inhibitors (PPIs) remain the main medical treatment for GERD, and current clinical guidelines also cover lifestyle changes, surgery, and endoscopic treatments, along with concerns about long-term PPI use and overprescribing.
How does VA rate GERD?
VA rates GERD under diagnostic code 7206 in the rating schedule. The rating depends on whether you have a documented history of esophageal stricture and how it’s treated.
Here is a plain-language summary of the criteria:
- 80%: Recurrent or hard-to-treat (refractory) stricture causing trouble swallowing, with aspiration, undernutrition, or substantial weight loss, treated with surgery or a feeding tube (PEG tube).
- 50%: Recurrent or refractory stricture causing trouble swallowing that needs dilation (stretching) 3 or more times a year, dilation with steroids at least once a year, or a stent.
- 30%: Recurrent stricture causing trouble swallowing that needs dilation no more than 2 times a year.
- 10%: Documented stricture that requires daily medication to control trouble swallowing and is otherwise without symptoms.
- 0%: Documented history without daily symptoms or a need for daily medication.
The rating schedule’s notes say a stricture should be documented by a barium swallow, CT scan, or upper endoscopy (EGD). Complications of treatment outside the digestive system are rated separately under the right body system.
The exact wording in the regulation controls, and a VA rater applies it to your records.
What changed in 2024?
Before May 19, 2024, VA often rated GERD by comparison to hiatal hernia (diagnostic code 7346), which was based on symptoms. Under the hiatal hernia criteria in effect before the change:
- 60% covered symptoms such as pain, vomiting, significant weight loss, and vomiting blood or black stools with moderate anemia, or other symptom combinations causing severe impairment of health.
- 30% covered persistently recurrent upper stomach distress with trouble swallowing, heartburn (pyrosis), and regurgitation, along with chest, arm, or shoulder pain, causing considerable impairment of health.
- 10% covered two or more of the 30% symptoms at lesser severity.
The 2024 update to the digestive rating schedule gave GERD its own code and criteria based on objective findings, since VA concluded GERD’s lasting impairment comes from scarring that narrows the esophagus.
VA stated that the rule doesn’t disturb ratings already in effect. The final rule doesn’t spell out how claims that were pending on May 19, 2024 were handled. If you filed around that date, or you have an older GERD rating and are thinking about a claim for an increase, an accredited representative can tell you which criteria apply.
How GERD gets service connected
To receive a rating, GERD must be service connected. There are two main paths:
- Direct service connection: Evidence shows your GERD began or worsened during service.
- Secondary service connection: Your GERD is caused or worsened by a condition that’s already service connected, such as a mental health condition, or medicines taken for another service-connected condition. Medicines that can cause or worsen GERD include nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, tricyclic antidepressants, calcium channel blockers, and certain asthma medicines.
Digestive problems are common among veterans with mental health conditions. A study of more than 600,000 Iraq and Afghanistan veterans found that nearly 20% had a gastrointestinal disorder, and veterans with a mental health disorder were at least twice as likely to have one. The study looked at digestive disorders broadly rather than GERD alone, and an association doesn’t show that one condition caused the other.
Our guide to VA secondary conditions explains the secondary path, and our article on GERD secondary to PTSD covers that specific link.
What a medical opinion does
A medical opinion, often called a nexus letter, addresses whether your condition is “at least as likely as not” (a 50% or greater probability) related to service or to a service-connected condition. When the evidence is roughly balanced, VA’s reasonable doubt rule resolves the doubt in the veteran’s favor.
What a GERD medical opinion typically reviews
A physician preparing an opinion on GERD generally looks at the full picture, including:
- Service treatment records for reflux, heartburn, or swallowing symptoms during service
- The timeline of when symptoms started, when GERD was diagnosed, and how it has changed
- Test and procedure reports, such as endoscopy, barium swallow, or dilation records
- Medication history, including medicines taken for other service-connected conditions
- Other risk factors, such as weight, smoking, or hiatal hernia, which a careful opinion addresses rather than ignores
- Relevant medical research on the claimed link
The opinion should explain the physician’s reasoning and reach a conclusion either way.
An independent opinion depends on a physician’s genuine review of your records, and the physician may conclude the evidence doesn’t support a link. If you’d like a board-certified physician to review your records and provide an independent medical opinion, HealthSource offers this through a secure video visit.
What evidence matters for a GERD rating?
Because the current criteria focus on stricture and treatment, the most useful records show objective findings. Helpful evidence often includes:
- Imaging or endoscopy reports, such as a barium swallow, CT, or EGD showing a stricture
- Procedure records for each dilation, stent placement, or surgery, with dates
- Medication records showing daily treatment for trouble swallowing
- Weight and nutrition records, if you’ve had weight loss or undernutrition
- Service treatment records showing reflux or related symptoms during service, for direct claims
You may also have a Compensation and Pension (C&P) exam, where a VA examiner evaluates your condition. Our guide to what to expect at a C&P exam explains the process.
Why a GERD diagnosis alone may not be enough
Doctors often diagnose GERD from symptoms and history and may start treatment without testing. Tests such as an upper endoscopy are usually ordered when symptoms suggest a complication, another condition could be the cause, or symptoms continue despite treatment.
That matters for a rating, because the higher levels of diagnostic code 7206 depend on a documented stricture. If you have trouble swallowing, food getting stuck, or symptoms that don’t respond to medication, talk with your provider about whether further evaluation is appropriate for your health, separate from any claim.
How GERD fits into your combined VA rating
If you have more than one service-connected condition, VA doesn’t simply add the percentages. VA combines ratings using the “whole person” method, so two 10% ratings combine to 19% before rounding to the nearest 10%.
A 0% GERD rating doesn’t add to your combined percentage, but it does record that the condition is service connected. If the condition worsens later, you can ask VA to reevaluate it.
How to file a GERD claim
You can file a VA disability claim online, by mail using VA Form 21-526EZ, in person at a VA regional office, or with help from an accredited representative. Common steps include:
- Gather your records, including service treatment records, VA and private medical records, and test or procedure reports.
- Consider an intent to file if you’re filing on paper, which may help secure an earlier effective date while you gather evidence.
- Submit your claim and include any supporting statements from people who know about your symptoms.
- Attend your C&P exam if VA schedules one.
- Watch for VA’s decision, which explains the rating and the evidence considered.
You generally have up to 365 days from when you start your application to add evidence.
Getting help with your VA claim
HealthSource provides independent medical opinions only. It does not prepare, file, or represent VA claims. For help with the claim itself, VA-accredited attorneys, claims agents, and Veterans Service Organization representatives can assist, and you can find one through VA’s accreditation search.
When to seek medical attention
Contact a health care provider if you have trouble or pain when swallowing, unexplained weight loss, vomiting, or symptoms that keep getting worse despite treatment.
This is not an emergency service. If you have chest pain, vomit blood, have black or tarry stools, or food gets stuck and you can’t swallow, call 911 or go to the nearest emergency room. Chest pain can be a sign of a heart problem rather than reflux. If you’re in crisis or having thoughts of suicide, call or text 988 to reach the Suicide & Crisis Lifeline. Veterans can press 1.
Frequently asked questions
Can I get a higher rating than 10% for GERD?
Under the current criteria, ratings of 30% and higher require a recurrent esophageal stricture causing trouble swallowing. A 30% rating involves dilation up to 2 times a year, 50% involves dilation 3 or more times a year, dilation with steroids, or a stent, and 80% involves complications such as substantial weight loss treated with surgery or a feeding tube. Heartburn severity alone doesn’t meet these levels.
Can I get a VA rating for GERD without a stricture?
A documented history of GERD without daily symptoms or daily medication fits the 0% level. Ratings of 10% and higher refer to a documented esophageal stricture. A 0% rating can still establish service connection, which may matter if your condition worsens later.
Can GERD be secondary to PTSD or medications?
It can be claimed that way. Secondary service connection applies when a service-connected condition, or its treatment, causes or worsens GERD. Whether the evidence supports that link depends on your records and a physician’s review.
Does VA rate GERD and hiatal hernia separately?
They have separate diagnostic codes, and hiatal hernia is still rated using the stricture criteria. VA’s rule against “pyramiding” says the same disability or the same symptoms shouldn’t be rated under different diagnoses. How overlapping digestive conditions are rated depends on your records, so ask an accredited representative about your situation.
Who decides my GERD rating?
A VA rater reviews all the evidence and decides service connection and your rating. A medical opinion supports your claim, but it does not guarantee approval.
Talk to a physician about your records
If you’re preparing a VA claim and need an independent medical opinion, a board-certified physician at HealthSource can review your records in a secure video visit and give an honest assessment of whether the evidence supports a connection. Learn more about our veteran nexus services or book an appointment; current pricing is shown on the booking page.
Sources
- Electronic Code of Federal Regulations. Accessed October 24, 2026. 38 CFR 4.114: Schedule of Ratings, Digestive System. https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/subject-group-ECFR3aa61b1b8fa2b1b/section-4.114
- Department of Veterans Affairs. Federal Register. Published March 20, 2024; effective May 19, 2024. Schedule for Rating Disabilities: The Digestive System. https://www.federalregister.gov/documents/2024/03/20/2024-05138/schedule-for-rating-disabilities-the-digestive-system
- Electronic Code of Federal Regulations. Accessed October 24, 2026. 38 CFR 3.303: Principles Relating to Service Connection. https://www.ecfr.gov/current/title-38/chapter-I/part-3/subpart-A/subject-group-ECFR6e2d1b4f9c2c1de/section-3.303
- Electronic Code of Federal Regulations. Accessed October 24, 2026. 38 CFR 3.310: Disabilities That Are Proximately Due to, or Aggravated by, Service-Connected Disease or Injury. https://www.ecfr.gov/current/title-38/chapter-I/part-3/subpart-A/subject-group-ECFR6e2d1b4f9c2c1de/section-3.310
- Electronic Code of Federal Regulations. Accessed October 24, 2026. 38 CFR 3.102: Reasonable Doubt. https://www.ecfr.gov/current/title-38/chapter-I/part-3/subpart-A/subject-group-ECFR6e2d1b4f9c2c1de/section-3.102
- U.S. Department of Veterans Affairs. Accessed October 24, 2026. About Disability Ratings. https://www.va.gov/disability/about-disability-ratings/
- U.S. Department of Veterans Affairs. Accessed October 24, 2026. How to File a VA Disability Claim. https://www.va.gov/disability/how-to-file-claim/
- U.S. Department of Veterans Affairs, Office of General Counsel. Accessed October 24, 2026. Accreditation Search. https://www.va.gov/ogc/apps/accreditation/
- National Institute of Diabetes and Digestive and Kidney Diseases. Last reviewed July 2020. Definition & Facts for GER & GERD. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/definition-facts
- National Institute of Diabetes and Digestive and Kidney Diseases. Last reviewed July 2020. Diagnosis of GER & GERD. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/diagnosis
- Electronic Code of Federal Regulations. Accessed October 24, 2026. 38 CFR 4.14: Avoidance of Pyramiding. https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-A/section-4.14
- Code of Federal Regulations, 2023 edition. Accessed October 24, 2026. 38 CFR 4.114: Schedule of Ratings, Digestive System (version in effect before May 19, 2024). https://www.govinfo.gov/content/pkg/CFR-2023-title38-vol1/xml/CFR-2023-title38-vol1-sec4-114.xml
- National Institute of Diabetes and Digestive and Kidney Diseases. Last reviewed July 2020. Symptoms & Causes of GER & GERD. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes
- El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871-880. doi:10.1136/gutjnl-2012-304269. https://gut.bmj.com/content/63/6/871
- Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117(1):27-56. doi:10.14309/ajg.0000000000001538. https://doi.org/10.14309/ajg.0000000000001538
- Maguen S, Madden E, Cohen B, Bertenthal D, Seal K. Association of mental health problems with gastrointestinal disorders in Iraq and Afghanistan veterans. Depress Anxiety. 2014;31(2):160-165. doi:10.1002/da.22072. https://pubmed.ncbi.nlm.nih.gov/23494973/
Medical documentation supports your request but does not guarantee approval. Final decisions are made by your employer, insurance carrier, leave administrator, school, applicable state program, or the Department of Veterans Affairs.
This article is for informational purposes only and is not a substitute for professional medical advice.
This is not an emergency service. In an emergency, call 911 or go to the nearest emergency room.